Context

Out of respect for both science and medicine, the following propositions are open for discussion throughout the World-Wide Web.

Preface

These theses are intended to supply a re-visioning of the scientific foundations of health and medicine. Rather than making small adjustments to a body of medical knowledge which has been developing by accretion since the time of Hippocrates, this re-visioning starts with a firm rejection of the present reductionist foundations of medicine. The human body is not an inert vessel that can be fairly viewed in terms of a definable set of chemical reactions. Rather, it is a product of an evolutionary process that has been ongoing for billions of years, an evolutionary process that has been directed by natural selection. As such, it will be argued that evolutionary biology provides the only secure foundation for understanding our health and for improving the practice of medicine.

There are two misunderstandings that this basic statement might engender, misunderstandings which must be immediately flagged as errors. I will now dispose of these errors, before getting on with the main business at hand.

The first misunderstanding would be the notion that the present perspective marks a break from scientific materialism, that somehow it is being proposed that there is something basically wrong with physics, chemistry, or even organic chemistry. Such an interpretation would be quite wrong. All of physics and chemistry are fully accepted on the present view. Instead, what is rejected is the conjecture that physics and chemistry supply enough in the way of scientific theory or experiment for understanding the foundations of health and medicine which, as argued here, are evolutionary. But evolutionary theory is built on top of the physical sciences, and does not tilt against them.

The second misunderstanding would be that the present effort is an attempt to merely add evolutionary ideas to conventional reductionist biology and medicine. Some scientists have made such attempts, and those attempts are not entirely without merit. But the present view is that the scientific foundations which are offered for medicine in the medical schools of the United States and other Western countries, with their characteristic molecular-biological reductionism, are not valid scientifically. This is not to say that such foundations were not a reasonable basis for medicine in the period from 1950 to 1975. They were. But the last 35 years of research in biology have destroyed the scientific models that held sway during those 25 years, and part of the present treatment will be to present the gist of that recent research.